With much confusion regarding third doses for the COVID-19 vaccine in immunocompromised individuals, BC Childress, Owensboro Health director of outpatient pharmacy, said that recently updated guidance will help clarify mixed messages about eligiblity.
The U.S. Centers for Disease Control and Prevention (CDC) updated its guidance Thursday evening regarding administration of an additional booster dose of of the Pfizer Comirnaty COVID-19 vaccine.
While the U.S. Food and Drug Administration (FDA) has granted full approval of Pfizer’s Comirnaty vaccine, that approval does not cover a third booster dose, according to Childress. However, the FDA does have an Emergency Use Authorization (EUA) issued for a third full dose of Pfizer and Moderna for immunocompromised individuals.
From there, he said the CDC has to meet with the Advisory Committee on Immunization Practices (ACIP) to determine whether to recommend the vaccine or booster to the public and what demographics to recommend it to.
The process, he said, is complicated and can get confusing for the public to understand exactly who is eligible and who is not.
“As a COVID vaccine provider, like Owensboro Health, we are basically a contracted provider of the vaccine with the CDC, so we have to follow the CDC’s statement on it, and it has to match what’s in the [EUA], so there’s been so much competing news about who’s going to be eligible, and really, the final say is what comes out of the CDC as recommendation, so we finally got that last night,” he said.
What makes it even more complicated, he said, is that the updated guidance from the CDC on Thursday is only regarding the Pfizer vaccine, not Moderna or Johnson & Johnson.
However, the guidance has opened up eligibility for a larger population of individuals to receive an additional booster dose of the Pfizer vaccine.
As of Thursday, Childress said an additional Pfizer booster is recommended to anyone who is 65 years of age or older, anyone living in a long-term care setting and individuals 50 to 64 years of age with underlying medical issues.
Additionally, he said the booster is available to individuals ages 18 to 49 who have underlying medical conditions and those ages 18 to 64 who are at risk for COVID-19 exposure based on their profession, which would likely include health care workers.
The booster is recommended to help those individuals develop an even stronger immune response to COVID-19, according to Childress.
“That was approved because what we were seeing in a lot of the cases and a lot of the data is that patients that were fully vaccinated that maybe ended up getting a breakthrough case, it was because they had underlying immune conditions, and they weren’t building the same immune response as a normal, healthy individual was,” he said. “Now what we’re seeing is that immunity and antibody levels are starting to wane after a period of about six months, so now these populations are going to be eligible to come and get that booster.”
A full third dose of Moderna is still available and recommended for individuals who are considered immunocompromised, however, a booster dose has not been recommended or approved for Modern.
Childress said he foresees booster doses for Moderna and Johnson & Johnson being approved in the near future and slowly being rolled out to the public based on priority and vulnerability of each demographic of the population.
He said it is also likely for Pfizer to be approved for individuals ages five to 11 in the next several weeks, which he said will help expand immunity to a larger population.
With new and potential upcoming guidance regarding the vaccines and booster doses, he said the public can “hopefully see cases drop over the next six months to a year.”
Christie Netherton, firstname.lastname@example.org, 270-691-7360